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May 2018

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SPOTLIGHT

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CHILDHOOD OBESITY RESEARCH & NEWS

Spotlight

NCCOR to Present at the Society for Prevention Research and the American College of Sports Medicine 2018 Annual Meetings

March 29, 2018, NCCOR

NCCOR will highlight the Measures RegistryUser Guides, and Youth Compendium of Physical Activities at the Society for Prevention Research (SPR) 26th Annual Meeting May 29–June 1, 2018, in Washington, DC; and at the American College of Sports Medicine (ACSM) 65th Annual Meeting May 29–June 2, 2018, in Minneapolis, MN.

Dr. David Berrigan, from the National Cancer Institute, is hosting a technology demonstration at SPR entitled, “Measures Registry, User Guides, and Youth Compendium of Physical Activities: Tools for Childhood Obesity Prevention Research and Evaluation” on Wednesday, May 30, 2018, from 5:45 to 7:00 p.m. ET. Dr. Berrigan will show attendees how to access NCCOR tools and answer related questions.

NCCOR is also sharing resources and information in the exhibit hall throughout the SPR meeting related to various projects, including the Catalogue of Surveillance SystemsChildhood Obesity Declines, and more!

Dr. David Brown, from the Centers for Disease Control and Prevention, is presenting a poster at ACSM entitled, “NCCOR Measures Registry & User Guides: Highlights and Reach” on Thursday, May 31, 2018 from 9:00 to 10:30 a.m. CT. Dr. Brown will also answer questions related to the Measures Registry and User Guides.

Don’t forget to follow @NCCOR on Twitter and Facebook and use the hashtags #SPRConf18 and #ACSM18 to stay connected. We look forward to meeting everyone in Washington and Minneapolis!

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Publications & Tools

Ask the Experts Video Series

Ask the Experts video series is a marketing campaign led by the Global Obesity Prevention Center at The Johns Hopkins University to promote effective and sustainable obesity prevention and control policies around the world. The series features public health professionals from the United Kingdom, Chile, New Zealand and more. They’ll be discussing effective obesity prevention and control policies in their home countries.

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May Issue, Parks & Recreation Magazine

The May issue of Parks & Recreation magazine features an article by Dr. Keshia Pollack Porter on implementing “Play Streets”—promoting physical activity with temporary street closures—in four rural communities in Maryland, North Carolina, Oklahoma, and Texas. Play Streets emerged as a way to promote play and physical activity for children in neighborhoods without access to safe, well-maintained parks and playgrounds. Dr. Pollack details preliminary findings from the project supported by the Physical Activity Research Center and funded by the Robert Wood Johnson Foundation.

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FoodAPS Interactive Charts

A new data visualization tool, based on U.S. Department of Agriculture’s FoodAPS, includes several interactive charts on weekly food spending, weekly household food spending by food group and by type of retailer, and distance to the nearest supermarket and the household’s primary food store.

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Childhood Obesity Research & News

Innovative Healthy Lifestyles School-Based Public–Private Partnerships Designed to Curb the Childhood Obesity Epidemic Globally: Lessons Learned from the Mondelēz International Foundation

May 14, 2018, Food and Nutrition Bulletin

Abstract

Public–private partnerships (PPPs) have been recognized as central for addressing the childhood obesity epidemic. However, very few real-world examples have been published documenting the workings of effective PPPs. The objective of this article is to identify the factors that enabled the successful implementation of school-based PPPs focusing mainly on nutrition and physical activity in 7 countries located in Asia (China and India), Africa (South Africa), Europe (Germany, United Kingdom), and Latin America (Brazil and Mexico). We triaged qualitative data from (1) proceedings from 2 school-based healthy lifestyles program evaluation workshops in October 2013 and in May 2016; (2) Mondelēz International Foundation (MIF) annual country reports and MIF project reports; and (3) interviews with key program leaders from each program. Extracted data were mapped into each of the 11 guiding principles for effective PPPs recently developed by a multisectoral public–private group of stakeholders in the United States. Three of the 7 countries met all, and the remaining 4 met between 4 and 7 of the guiding principles. Therefore, it is not surprising that there is strong evidence that all programs are having a positive impact on healthy lifestyles knowledge and practices in the target populations. This MIF-led initiative provides important lessons as to how to establish effective PPPs designed to tackle the childhood obesity epidemic globally.

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Increased Overweight in Children of Mothers Who Drank Coffee While Pregnant

May 11, 2018, EurekAlert!

A study published in the BMJ Open journal shows that even moderate coffee consumption during pregnancy, one to two cups per day, is related to a risk of overweight or obesity in school age children. It has not been clearly shown if caffeine is the direct cause of the overweight, but the relationship, alone, has caused researchers to encourage increased caution.

“There may be good cause to increase the restriction of the recommended maximum of three cups of coffee per day. Caffeine is not a medicine that needs to be consumed,” says Verena Sengpiel, Associate Professor in obstetrics and gynecology at Sahlgrenska Academy, Sweden, and specialist physician at the Department of Obstetrics and Gynecology at Sahlgrenska University Hospital.

Researchers at Sahlgrenska Academy, in collaboration with the Norwegian Institute of Public Health, studied information on 50,943 pregnant women, in one of the world’s largest health surveys of pregnant women, the Norwegian Mother and Child Cohort Study (MoBa).

The results show that children born to mothers who consumed caffeine during pregnancy are at greater risk of being overweight at preschool and school ages. Children were followed until eight years of age. Being overweight in childhood has previously been linked to increased risk of cardiovascular disease and Type 2 diabetes later in life.

For example, at age five, the share of children who were overweight or obese was five percent greater in the group whose mothers had the highest caffeine consumption in the study, compared to those whose mothers had the lowest caffeine consumption.

The association between caffeine consumption during pregnancy and the risk of excess growth and overweight or obesity in children could also be seen in women who had followed the recommended amount for pregnant women. According to the National Food Agency, Sweden, pregnant women should not consume more than 300 milligrams of caffeine per day, which is equivalent to three cups of coffee (1.5 dl each) or six mugs of black tea (2 dl each).

The results of the current study are supported by at least two other studies; however, these included significantly fewer subjects and fewer sources of caffeine. This time, coffee, tea, chocolate, energy drinks and other sources were included.

“In the Nordic countries, coffee is the primary source, while, women in, for example, England receive the greatest amount of caffeine from black tea. If you look at mothers in the younger age group, it comes from energy drinks. We included different sources in the study and found a similar association between caffeine consumption from these different sources and children’s growth,” says Verena Sengpiel.

In general, the gestational environment is viewed as being important in the turning off and on of genes and metabolic programming for the duration of life. Previous animal studies, where embryos were exposed to caffeine in the womb, were also followed by excess growth and cardiometabolic disease in the offspring.

“Even if more studies are needed before we can say what this finding really means, caffeine is a substance that you can choose to reduce consumption of or completely refrain from during pregnancy,” notes Verena Sengpiel.

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Trends in Socioeconomic Disparities in Obesity Prevalence Among Low-Income Children Aged 2–4 Years in Los Angeles County, 2003–2014

May 9, 2018, Childhood Obesity

Abstract

Background: Obesity prevalence among low-income preschool-aged children in the United States decreased between 2010 and 2014. However, this decreasing trend may be varied across socioeconomic subgroups. This study examined trends in obesity prevalence among low-income children from 2003 to 2014 by child’s age and household and neighborhood socioeconomic status (SES).

Methods: This study used administrative data for all children, aged 2–4 years, participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Los Angeles County (LAC) during the years 2003–2014. Obesity was defined as having a BMI ≥95th percentile of CDC’s age- and sex-specific growth charts. Household income and household educational attainment were indicators of household SES. Neighborhood median household income was an indicator of neighborhood SES.

Results: Childhood obesity prevalence increased sharply from 15.7% in 2003 to 19.1% in 2005, and remained constant until 2010, when it started decreasing. During most years, the prevalence of obesity was higher among the lowest SES groups. Despite the recent decreasing trend, the 2014 estimates were still generally higher than the 2003 levels except among some low-income children living in less-poor and more-educated households.

Conclusions: The decreasing trend between 2010 and 2014 among WIC-participating children in LAC is encouraging and mirrors national trends among WIC-participating children. However, continued efforts should be made to focus obesity prevention efforts on low-income children, especially those who are the most vulnerable as they have experienced significant gains in obesity since 2003.

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Classroom-Based Physical Activity and Sedentary Behavior Interventions in Adolescents: A Systematic Review and Meta-Analysis

May 2018, Journal of Physical Activity & Health

Abstract

Background: It is reported that 81% of adolescents are insufficiently active. Schools play a pivotal role in promoting physical activity (PA) and reducing sedentary behavior (SB). The aim of this systematic review and meta-analysis was to evaluate classroom-based PA and SB interventions in adolescents.

Methods: A search strategy was developed using the Population Intervention Comparison Outcome Study (PICOS) design framework. Articles were screened using strict inclusion criteria. Study quality was assessed using the Effective Public Health Practice Project quality assessment tool (http://www.ephpp.ca/tools.html). Outcome data for preintervention and postintervention were extracted, and effect sizes were calculated using Cohen’s d.

Results: The strategy yielded 7,574 potentially relevant articles. Nine studies were included for review. Study quality was rated as strong for 1 study, moderate for 5 studies, and weak for 3 studies. Five studies were included for meta-analyses, which suggested that the classroom-based interventions had a nonsignificant effect on PA (P = .55, d = 0.05) and a small, nonsignificant effect on SB (P = .16, d = −0.11).

Conclusion: Only 9 relevant studies were found, and the effectiveness of the classroom-based PA and SB interventions varied. Based on limited empirical studies, there is not enough evidence to determine the most effective classroom-based methodology to increase PA and SB.

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Los Angeles Tests the Power of ‘Play Streets’

April 29, 2018, The New York Times

The temporary transformation of Fickett Street in Boyle Heights began with yellow shades resembling huge kites suspended over the sun-scorched asphalt. Soon, a thoroughfare known for its speeding vehicles and gang activity became something else entirely — a “play street” in which women gathered for Lotería, or Mexican bingo, and kids fashioned seesaws out of giant snap-together plastic shapes in colors inspired by local Mexican-American murals.

There are roughly 7,500 miles of streets in Los Angeles, and Fickett Street is only one of them. But in this predominantly Latino neighborhood where parks are scarce, residents and activists have begun a design intervention to reclaim streets for civic life, kibitzing and play. From London to Los Angeles, the play street concept, known as “playing out” in England, has become an international movement of sorts, especially in low-income communities that lack green space and other amenities.

The efforts in Boyle Heights, a 6 ½-mile area bisected by six freeways, is a collaboration between Union de Vecinos, a group of neighborhood leaders, and the Kounkuey Design Initiative, or KDI, a nonprofit public interest design firm that helps underserved communities realize ideas for productive public spaces.

The Los Angeles Department of Transportation has invested $300,000 on 15 KDI-designed pilot play streets this year in Boyle Heights and Koreatown, another heavily trafficked neighborhood. Seleta Reynolds, the general manager of the LADOT, first became aware of the concept while visiting Copenhagen.

“I was struck by the power of these interventions,” she said. “There is something irresistible about being in the middle of a place — a street — where you’re normally not allowed to go.”

On a recent Sunday, Kounkuey unveiled its “playground in a box.” Shade structures stretched across Fickett Street, affixed to loquat trees and no-parking signs, and the plastic “wobbles” created by KDI doubled as Tilt-a-Whirls, BarcaLoungers, and formidable hurdles for teenage skateboarders. Nine-year-old Amanda Alvarado built a McMansion. “Ava, lookit!” she exclaimed to her 4-year-old sidekick in pink pom-pom slippers.

The Fickett Street play street, the neighborhood’s fourth since the LADOT pilots began in 2016, was sought by Union de Vecinos as a safe and celebratory refuge. Perched on a bluff overlooking downtown and separated by the Los Angeles River, Boyle Heights, a neighborhood of about 100,000 residents, has long suffered from a host of land-use inequities, including its proximity to polluting freeways that decimated housing and sliced the community’s largest park in half.

Three-quarters of the housing units in Boyle Heights are currently rentals. And the fact that the neighborhood is near the downtown Arts District across the river has brought the issue of displacement to the fore. Art galleries and house flippers have moved in and longtime tenants have received eviction notices, raising the specter of “Ikea catalogs in the barrio,” as Josefina López, the artistic director of Casa 0101 Theater and the writer of “Real Women Have Curves,” put it.

In her play “Hipsteria,” Ms. López imagined the last building in Boyle Heights 20 years hence, occupied by hipsters wanting to turn it into a dog hotel. “Boyle Heights is not a blank canvas,” she observed. “It’s a rich tapestry of immigrant history, culture and activism.”

It has long been an immigrant hub: The historic Breed Street Shul was the oldest Orthodox synagogue west of Chicago. (The rear building is now a community center.) The neighborhood’s landscape is distinctly Latino, with artful front-yard altars dedicated to the Virgin of Guadalupe and Mexican-American murals bringing vibrant life to peeling walls.

In recent years, Union de Vecinos has been deeply involved in pro-tenant and antigallery activism, some of it confrontational. (Several galleries, including the artist-run 356 Mission, have announced they will close here.) But over the past two decades, its leaders have also worked hard to make the neighborhood cleaner and safer in the face of longstanding disinvestment. The alleyways crisscrossing the neighborhood were especially dangerous, filled with trash by people pulling off the freeways to dump construction waste, and had become magnets for illegal activity.

The group got rid of the litter and gang graffiti, installed brightly painted speed bumps and, in an alley near a liquor store, planted a garden full of spiky cactuses.

But improving the neighborhood has become a delicate proposition. As the area becomes more habitable for residents, it grows more appealing to outsiders, putting more pressure on housing. On Avenue Cesar E. Chavez, the primary commercial street, for instance, young people with laptops and earbuds sip coffee across the street from a lone Norteño accordionist in a sombrero standing beneath a red awning.

“There’s a difference between making something beautiful to sell it and making it useful,” said Leonardo Vilchis, co-director of Union de Vecinos. “So the question is, can we make this place more livable for people living here now?”

With tensions about gentrification running high, the community’s decision to embrace the play street concept was not a casual one.

“So many people want to come in and modify this place,” said Ofelia Platon, 45, a Union de Vecinos leader who lives around the corner from Fickett Street. “So there’s always a question of what would we need to give up?” A mother of three, she recalled taking her son Esteban, now 17, to a nearby park and having to drop on the grass because of a shooting.

The residents chose Fickett Street with the intention of providing a safe space not just for children but for the community, said Chelina Odbert, KDI’s co-founder and executive director.

“What a play street is not is a replacement for permanent parks,” she said. “But it bridges the gap in a way that’s really needed.”

Scarlett De Leon, a director for the Koreatown Immigrant Workers Alliance, grew up there and said she spent much of her childhood glued to television, a pattern she now observes in her younger siblings and her great-grandmother.

“It’s a cycle that affects different generations in one family,” she said. “So having a space to be creative and interact is important for emotional health.”

At the play street event earlier this month, Fickett Street was alive with fathers pushing play bins down the street with children riding in them. The scent of taquitos drifted from Maria Lopez’s kitchen — she made enough for everyone — and young men helped carry jars of watermelon agua fresca down the steps.

Miguel Ángel Jiménez, 18, attempted to jump a wobble with his skateboard. “I feel better when people are interested in each other,” he said of the street. “There’s a time to be indoors and a time to be out.”

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